Ulcerative Colitis

Question 1

Ulcerative Colitis subtypes:

Answer 1

Proctitis (40-50%)
Extensive Colitis (30-40%)
Pancolitis (20%)

Question 2

Ulcerative Colitis has two peaks:

Answer 2

• Major peak in young adults (15-30y/o)

- Smaller peak in elders (50-70y/o).

Question 3

Symptoms: Ulcerative Colitis

Answer 3

Diarrhoea (this can be chronic or episodic, and often contains blood, mucus, or pus)
Abdominal pain (cramp-like)
Anorexia
Weight loss
Malaise.

Tenesmus (a continual or recurrent inclination to evacuate the bowels)

*Severity of symptoms correlates with the extent of the disease.

Question 4

Signs: Ulcerative Colitis

Answer 4

Tachycardia
Tender-distended abdomen
Fever
Extra-intestinal manifestations: 
- Finger clubbing
- Aphthous Ulcerations
- Erythema Nodosum 
- (could be none)

Question 5

Investigations: Ulcerative Colitis

Answer 5

Barium enema
Bloods (FBC, ESR, CRP, U&E, LFT, Blood Culture),
Stool MC&S/CDT (Faecal Calprotectin is raised in inflammatory conditions), CXR (to exclude perforation; if there was then you see free air under diaphragm), Colonoscopy, CT (to exclude perforation), Abdominal Ultrasound,

Question 6

Inflammation Markers: Ulcerative Colitis

Answer 6

Inflammation Markers: - Increased: 
ESR
CRP
Platelet Count
White Cell Count.                         
                                          Decreased:
Haemoglobin
Albumin

Question 7

Treatment for Crohns/Ulcerative Colitis:

Answer 7

Biologics
Immunosuppressant's (Methotrexate, Infliximab, Mercaptopurine, AZA - Azathioprine)
Steroids (Prednisilone, Hydrocortisone (give this first)
Surgery (Colectomy)
5ASA (5 Aminosalicylate)
Metronidazole
Optimise nutrition
Blood transfusion